Association of Non-Alcoholic Fatty Liver Disease and Hepatic Fibrosis with Epicardial Adipose Tissue Volume and Atrial Deformation Mechanics in a Large Asian Population Free from Clinical Heart Failure

Abstract

Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease share several cardiometabolic risk factors. Excessive visceral fat can manifest as ectopic fat depots over vital organs, such as the heart and liver. This study assessed the associations of NAFLD and liver fibrosis with cardiac structural and functional disturbances. We assessed 2161 participants using ultrasound, and categorized them as per the NAFLD Fibrosis Score into three groups: (1) non-fatty liver; (2) fatty liver with low fibrosis score; and (3) fatty liver with high fibrosis score. Epicardial fat volume (EFV) was measured through multidetector computed tomography. All participants underwent echocardiographic study, including tissue Doppler-based E/e’ ratio and speckle tracking-based left ventricular global longitudinal strain, peak atrial longitudinal strain (PALS), and atrial longitudinal strain rates during systolic, early and late-diastolic phases (ALSRsyst, ALSRearly. ALSRlate). Larger EFV, decreased e’ velocity, PALS, ALSRsyst, and ALSRearly, along with elevated E/e’ ratio, were seen in all groups, especially in those with high fibrosis scores. After multivariate adjustment for traditional risk factors and EFV, fibrosis scores remained significantly associated with elevated E/e’ ratio, LA stiffness, and decreased PALS (β: 0.06, 1.4, −0.01, all p < 0.05). Thus, NAFLD is associated with LV diastolic dysfunction and subclinical changes in LA contractile mechanics.

Non-Alcoholic Fatty Liver Disease and Echocardiographic Parameters of Left Ventricular Diastolic Function: A Systematic Review and Meta-Analysis

“…From the initial search, 2619 studies were identified. Ultimately, 38 of them were included in the systematic review [ 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. Furthermore, 31 of them were found eligible for meta-analysis ( Figure 1 ), since 7 of the studies included in the systematic review did not have the required quantitative data.…”

MASLD and MASH at the crossroads of hepatology trials and cardiorenal metabolic trials

“…For example, exercise testing and coronary calcium scoring can help identify ischemic heart disease, N-terminal pro-b-type natriuretic peptide measurements and cardiac ultrasound can help identify HF, cardiac CT is useful to diagnosing valve diseases, and Holter monitoring can detect atrial fibrillation [85]. Useful NITs to diagnose and monitor CV disease are shown in Table 3 [61,[85][86][87][88].…”

Advances and Challenges in Diagnosis and Management of Heart Failure

“…can complicate accurate and timely diagnosis of HF. Lai et al found that non-alcoholic fatty liver disease without HF is associated with left ventricular diastolic dysfunction and subclinical changes in left atrial contractility [8]. Adamska-Welnicka et al reviewed the difficulty associated with proper HF diagnosis when comorbidities of chronic kidney disease or pulmonary hypertension are present [9].…”